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10070109I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10993 NORTHSKY SQ OWNER'S NAME: JOAN D LOPES NER'S PHONE: 2098390671 LICENSED CONTRACTOR'S DECLARATION License Class — Lic. # �[-:a Contract Date f�9 I O I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this p it. Addi 'onally, the plicant understands and will comply with all non-poin s urce r ations per h Cupertino Municipal Code, Section 9.18. Signature Date OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save i—lemnify and keep harmless the City of Cupertino against liabilities, judgments, and expenses which may accrue against said City in consequence of the r ...sting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date CONTRACTOR: FOUR SEASONS ROOFING PERMIT NO: 10070109 PO BOX 1668 DATE ISSUED: 07/15/2010 SAN JOSE, CA 95109 PHONE NO: (408)278-0330 BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r MECH F RESIDENTIAL F COMMERCIAL F JOB DESCRIPTION: RE -ROOF RMV EXSTNG CEMWOOD ROOF & INSTALL A NEW CLASS A COMP SHINGLE. GAF GRAND CANYON (COLOR)STONEWOOD 12SQ Sq. Ft Floor Area: APN Number: 31640004.00 Valuation: $4400 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Ti�� '�—�"_v Date: 7l -1 RE -ROOFS: All roofs shall be inspected rior t any roofin aterial being installed. If a roof is installed without fiL btai g ' spection, gree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the 90pertino Municipal Code, Chapter 9.12 and the Health & Safety Code, SKOor 505, 25533, and 25534. Owner o thorized a Ent: Date: I CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO wo FEE ESTIMATOR -- BUILDING DIVISION NOTE: These fees are based on the nreliminary information c vailable and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Hee Resolution 09-051 Eff.' ?''1.,"09) ADDRESS: DATE: MISC ITEMS REVIEWED BY: APN: BP#: -VALUATION: 1$4,400 PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: TOTAL ROOF AREA: 1,200 S f APPLICATION 1 R3SFDADD/REM TYPE: J as 3� NOTE: These fees are based on the nreliminary information c vailable and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Hee Resolution 09-051 Eff.' ?''1.,"09) FEE QTY/FEE MISC ITEMS Permit Fee: $15E.00 J Work Without Permit? Q Yes (F) No $C.00 Strong; Motion Fee: IBSEISMICR $C.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: 1 $157.501 $0.00 TOTAL FEE: $157.50 Revised: 6/30/2010 CITY OF CUPERTINO 2 ITEMS OF 10 PERMI`C RECEIPT Sec: Twp: Rng: Sub: Bl:,�: Lot: APN ........: 31,540004.00 DATE ISSUED.......: 07,/15/2010 RECEIPT #.........: BS)00010874 REFERENCE ID # ...: 10)70109 SITE ADDRESS .....: 10393 NORTHSKY SQ SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER ............: JOAN D LOPES ADDRESS ..........: 10)93 NORTHSKY SQ CITY/STATE/ZIP ...: CU:?ERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM ....: F01JR SEASONS ROOFIN CONTRACTOR .......: DIAZ, ALFRED LIC # 21323 COMPANY ..........: F01JR SEASONS ROOFING ADDRESS ..........: PO BOX 1668 CITY/STATE/ZIP ...: SAN JOSE, CA 95109 TELEPHONE ........: (4)8)278-0330 FEE ID UNIT QUANTITYIU40UNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 4,400.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 ---------- 0.00 1REROOFRES SQ FEET 12.00 156.00 0.00 156.00 0.00 TOTAL PERMIT ---------- 157.00 ---------- 0.00 ---------- 157.00 ---------- 0.00 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF go;011s CITY OF CITY OF CUPERTINO REROOF CUPERTINO PERMITAPPLICATION ( v< 7 c)i k�>A APN � 4� C) C, Date: 711 tO0 l Building Address: Owner's Name: -o L pe S Phone #: �� g3 9' 6(=, Z / HOA: Yes No If yes, provide letter from HOA Contractor: r , �—T ,c, dv Phone #: Fax #: 6eV.27,?--d333 Cupertino Business License #: X13 23 Contractor License #: 8, Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles 3e- Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles Other (Specify) uwo 0 00 ❑ Other (Specify) fir- Number of existing coverings �_ ❑ Provide I.C.C.E.S. Report # via -To be Removed ❑ Provide Mfgr. Installation Specs. r't!J ve .. 54 /u G2� �'�'`rk (mac' Job Description: `- � 4To�. � L�Kg A!�: Residential - Commercial Green Building: Please complete relevant portion of the Confirmed with.Planning Dept. if Green Building Checklist & attach it to tt.e application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: a yoO _ I Have Read, Understand and Will Comply vvith Cupertino's Tear -Off Policy: Signature Revised 02/05/09 CUPERTINO PRuILCI .ADDRESS /0 REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingecupertino.org 3 9 _ I APN # CONTiL4Cl OR NA41E ! LIC COMPANY NAME PHONr 1P`^" CIT r, STATE IP ENJ BER LICEN� gf E-MAIL c' FAX N ZZ _ 4 cr> 1 BUS. LIC. # Z3 FAX p333 STREL.� a R6S CITi,STATE, ZP PHONE . � �5 u! • _ _ cid✓! , � 5%�Z U 3 3 p I UNDERSTAND ANI) AGREE TO THE FOLLOWING: The re -roof project shall comply with all applicable provisions of the 2007 California Building Code. An inspection request shall be scheduled the day before the inspection date. Please call (408)777- 3228 between 7:30 - 3:30pm (Mon -Fri) to schedule the next day inspection. 3. After the roof is torn off and the nails/fasten ,-rs have been removed and all the dry -rotted wood has been replaced, you must call for a roof inspection. A building inspector will be available with one hour. There are special hours for the service: 7:30 — 10:30am and 1:00 — 3:30pm (Mon — Thurs); 7:30 — 10:30am and 1:00 — 2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. New roof coverings shall not be applied without first obtaining all inspection and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. A final inspection and approval shall be obtained from the building inspector when the re -roofing is completed. To receive a final sign -off, the following item will be verified: a. Flat roofs shall have a minimum of/" per fo )t of slope and demonstrate there is no ponding. b. A listing from an approved testing agency shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 7. NOTE: If you call for a plywood nailing inspection and the job is not ready, you will be charged to a re- inspection fee of $126.00. The re -inspection fee shall be paid before another inspection can be scheduled. By my signature below, I certify to each of the follcwing: I am the property owner or authorized agent to act on the property owner's behalf. I u erpand and agree to comply with the re -roof policy stated above. Signature of Applicant/Agent: -- Date: //� ReroofPo1icy_2010.doc revised 04114,10